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Improvement in glycaemic control in patients with type 2 diabetes with treatment using an interactive mobile application – A pilot study from India

Published:October 25, 2022DOI:https://doi.org/10.1016/j.pcd.2022.10.008

      Highlights

      • Mobile applications have become popular in providing healthcare services.
      • A case-control study was conducted to assess the effectiveness of ‘Diahome app’.
      • Glycaemic improvement was significantly better with Diahome than usual approach.
      • Patients found real-time virtual consultation convenient and acceptable.

      Abstract

      Aims

      We studied the outcome of glycaemic management using Diahome, a smart-phone application compared to conventional treatment. Overall acceptability of the application among users was also assessed.

      Methods

      This is a retrospective, case-control study of patients on virtual diabetes care using the Diahome app (n = 441) and those visited the hospital out-patient services (n = 446) between April and June 2021. Men and women aged 45–60 years with type 2 diabetes (T2DM) were selected.

      Results

      A total of 173 records with initial and follow-up visits were analyzed (app users n = 91, non-app users n = 82). Participants were aged 59 ± 12 years and were obese. The two groups were similar by age, gender distribution and duration of T2DM. Fasting blood glucose significantly reduced only among the app-users from a baseline level of 156 ± 70 mg/dl to 129 ± 40 mg/dl at follow-up (p < 0.02). Reduction in HbA1c levels was observed in both groups (p < 0.0001); percentage improvement was better among app (15.8%) than in non-app users (10.4%), p = 0.004. Triglycerides level were higher at both time points among app-users (p < 0.05) as compared to the other group. More than 56% of the users rated the performance of Diahome app as excellent; virtual consultation was rated the highest (71.5%) among the Diahome services.

      Discussion

      Glycaemic management of diabetes using a dedicated mobile application was superior to in-person hospital visits. Its long-term effectiveness and cost savings need to be ascertained.

      Keywords

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      References

        • Seivert S.
        • Badowski M.E.
        The rise of telemedicine: lessons from a global pandemic.
        EMJ Innov. 2020; 59: 64-69https://doi.org/10.33590/emjinnov/20-00239
        • Battineni G.
        • Sagaro G.G.
        • Chintalapudi N.
        • Amenta F.
        The benefits of telemedicine in personalized prevention of cardiovascular diseases (CVD): a systematic review.
        J. Pers. Med. 2021; 11: 658https://doi.org/10.3390/jpm11070658
        • Kesavadev J.
        • Krishnan G.
        • Mohan V.
        Digital health and diabetes: Experience from India.
        Ther. Adv. Endocrinol. Metab. 2021; 12https://doi.org/10.1177/20420188211054676
        • Vinitha R.
        • Nanditha A.
        • Snehalatha C.
        • et al.
        Effectiveness of mobile phone text messaging in improving glycaemic control among persons with newly detected type 2 diabetes.
        Diabetes Res Clin. Pr. 2019; 158107919https://doi.org/10.1016/j.diabres.2019.107919
        • Ramachandran A.
        • Jain S.M.
        • Mukherjee S.
        • et al.
        Suboptimal Glycemic Control Among Subjects With Diabetes Mellitus In India: A Subset Analysis Of Cross-Sectional Wave-7 (2016) Data From The International Diabetes Management Practices Study (IDMPS).
        Ther. Adv. Endocrinol. Metab. 2020; 11https://doi.org/10.1177/2042018820937217
        • Misra A.
        • Sattar N.
        • Tandon N.
        • et al.
        Clinical management of type 2 diabetes in South Asia.
        Lancet Diabetes Endocrinol. 2018; 6: 979-991https://doi.org/10.1016/S2213-8587(18)30199-2
        • Nair D.R.
        • Satheesh K.
        • Raghavan A.
        • et al.
        Trend In The Clinical Profile Of Type 2 Diabetes In India - Study From A Diabetes Care Centre In South India.
        Diabetes Metab. Syndr. 2020; 14: 1851-1857https://doi.org/10.1016/j.dsx.2020.09.018
        • Mohan V.
        • Shah S.N.
        • Joshi S.R.
        • et al.
        Diabcare India 2011 Study Group. Current Status Of Management, Control, Complications And Psychosocial Aspects Of Patients With Diabetes In India: Results From The Diabcare India 2011 Study.
        Indian J. Endocrinol. Metab. 2014; 18: 370-378https://doi.org/10.4103/2230-8210.129715
        • Arun R.
        • Nanditha A.
        • Satheesh K.
        • et al.
        The profile of clinically diagnosed new type 2 diabetes among Asian Indians.
        Endocrinol. Diabetes Metab. J. 2020; 4: 1-4https://doi.org/10.31038/EDMJ.2020434
        • Murugesan N.
        • Snehalatha C.
        • Shobhana R.
        • et al.
        Awareness about diabetes and its complications in the general and diabetic population in a city in Southern India.
        Diabetes Res Clin. Pr. 2007; 77: 433-437https://doi.org/10.1016/j.diabres.2007.01.004
        • Fleming G.A.
        • Petrie J.R.
        • Bergenstal R.M.
        • et al.
        Diabetes Digital App Technology: Benefits, Challenges, and Recommendations. A Consensus Report by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group.
        Diabetes Care. 2020; 63: 229-241https://doi.org/10.2337/dci19-0062
      1. Ministry of Health and Family Welfare, Telemedicine practice guidelines [internet]. New Delhi, 2020. Available from 〈https://www.mohfw.gov.in/pdf/Telemedicine.pdf〉.

        • De Groot J.
        • Wu D.
        • Flynn D.
        • et al.
        Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: a meta-analysis.
        World J. Diabetes. 2021; 12: 170-197https://doi.org/10.4239/wjd.v12.i2.170
        • Kesavadev J.
        • Saboo B.
        • Shankar A.
        • et al.
        Telemedicine for diabetes care: an indian perspective - feasibility and efficacy.
        Indian J. Endocrinol. Metab. 2015; 19: 764-769https://doi.org/10.4103/2230-8210.167560
        • Zhang B.
        Expert consensus on telemedicine management of diabetes (2020 Edition).
        Int J. Endocrinol. 2021; 2021: 6643491https://doi.org/10.1155/2021/6643491
        • WHO guideline
        Recommendations on Digital Interventions for Health System Strengthening.
        World Health Organization,, Geneva2019 (Licence: CC BY-NC-SA 3.0 IGO)
        • Phillip M.
        • Bergenstal R.M.
        • Close K.L.
        • et al.
        The digital/virtual diabetes clinic: the future is now-recommendations from an international panel on diabetes digital technologies introduction.
        Diabetes Technol. Ther. 2021; 23: 146-154https://doi.org/10.1089/dia.2020.0375
        • Sarveswaran G.
        • Rangamani S.
        • Ghosh A.
        • et al.
        Management Of Diabetes Mellitus Through Teleconsultation During COVID-19 And Similar Scenarios - Guidelines From Indian Council Of Medical Research (ICMR) Expert Group.
        Diabetes Metab. Syndr. 2021; 15102242https://doi.org/10.1016/j.dsx.2021.102242
        • Chan C.B.
        • Popeski N.
        • Hassanabad M.F.
        • et al.
        Use of virtual care for glycemic management in people with types 1 and 2 diabetes and diabetes in pregnancy: a rapid review.
        Can. J. Diabetes. 2021; 45: 677-688.e2https://doi.org/10.1016/j.jcjd.2021.02.007
        • Hood K.K.
        • Wong J.J.
        Telehealth for people with diabetes: poised for a new approach.
        Lancet Diabetes Endocrinol. 2022; 10: 8-10https://doi.org/10.1016/S2213-8587(21)00312-0
        • Wong V.W.
        • Wang A.
        • Manoharan M.
        Utilisation of telehealth for outpatient diabetes management during COVID‐19 pandemic: how did the patients fare?.
        Intern Med J. 2021; 51: 2021-2026https://doi.org/10.1111/imj.15441
        • Anjana R.M.
        • Pradeepa R.
        • Deepa M.
        • et al.
        Acceptability and utilization of newer technologies and effects on glycemic control in type 2 diabetes: lessons learned from lockdown.
        Diabetes Technol. Ther. 2020; 22: 527-534https://doi.org/10.1089/dia.2020.0240
        • Nanditha A.
        • Snehalatha C.
        • Satheesh K.
        • et al.
        Secular Trends In Diabetes In India (Stride-I): Change In Prevalence In 10 Years Among Urban And Rural Populations In Tamil Nadu.
        Diabetes Care. 2019; 42: 476-485https://doi.org/10.2337/dc18-1559
        • Ramachandran A.
        • Kumar R.
        • Nanditha A.
        • et al.
        Mdiabetes initiative using text messages to improve lifestyle and health-seeking behaviour in India.
        BMJ Innov. 2018; https://doi.org/10.1136/bmjinnov-2017-000265
        • Ramachandran A.
        • Snehalatha C.
        • Ram J.
        • et al.
        Effectiveness of mobile phone messaging in prevention of type 2 diabetes by lifestyle modification in men in India: a prospective, parallel-group, randomised controlled trial.
        Lancet Diabetes Endocrinol. 2013; 1: 191-198https://doi.org/10.1016/S2213-8587 (13)70067-6